Handheld Lung Ultrasound to Detect COVID-19 Pneumonia in Inpatients: A Prospective Cohort Study

Area of Science:

• Medical Imaging
• Infectious Diseases
• Pulmonology

Background:

• Chest X-ray (CXR) and CT scans aid in COVID-19 diagnosis but have limitations.
• Lung point-of-care ultrasound (POCUS) offers a rapid, portable alternative, especially for low-resource settings.
• A standardized POCUS protocol needs validation for COVID-19 pneumonia diagnostic accuracy.

Purpose of the Study:

• To evaluate the diagnostic performance of a standardized lung POCUS protocol with handheld devices.
• To detect patients with either a positive nucleic acid test (NAT) or a COVID-19-typical CT pattern.

Main Methods:

• Adult inpatients with suspected/confirmed COVID-19 and CT scans were enrolled.
• A handheld POCUS device was used to scan twelve lung zones.
• Images were scored by blinded experts; patients were categorized by suspicion level.

Main Results:

• POCUS demonstrated an AUC of 0.787 for positive NAT and 0.820 for typical CT.
• Sensitivity reached 0.90 (NAT) and 1.00 (CT) at the lower cutoff.
• Specificity was 0.90 (NAT) and 0.89 (CT) at the higher cutoff.

Conclusions:

• The standardized lung POCUS protocol with handheld devices shows reasonable diagnostic performance for COVID-19 pneumonia.
• POCUS can be a valuable adjunct for diagnosing COVID-19 pneumonia, particularly in resource-limited environments.